Should we recommend universal aspirin for all pregnant women?

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Pharmacology

Background:

• Low-dose aspirin use is established for reducing preeclampsia and fetal growth restriction in high-risk pregnancies.
• The efficacy and optimal strategy for low-risk populations remain unclear.
• Emerging screening tests offer early preeclampsia risk prediction.

Purpose of the Study:

• To discuss controversies surrounding low-dose aspirin's impact on preeclampsia.
• To analyze discrepancies in national guidelines for aspirin use.
• To evaluate the cost-effectiveness and efficacy of novel screening tests versus universal aspirin prophylaxis.

Main Methods:

• Review of current literature on low-dose aspirin for preeclampsia prevention.
• Analysis of guidelines from major obstetric and gynecological societies.
• Discussion of emerging preeclampsia screening technologies.

Main Results:

• Conflicting opinions exist regarding the universal application of low-dose aspirin.
• National guidelines vary in their recommendations for aspirin initiation based on risk factors.
• The cost-effectiveness and clinical utility of new screening tests are under debate.

Conclusions:

• The optimal approach to preeclampsia prevention with low-dose aspirin requires further investigation.
• Universal first-trimester aspirin prophylaxis may be a viable alternative to current screening protocols.
• Balancing efficacy, cost, and patient acceptability is crucial in developing future preeclampsia management strategies.